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Change Impact Statement Template

This document communicates the impact of a requested project change. It includes the change request number, description of the change, and whether the change would impact the project's budget, schedule, scope, deliverables, resources, or quality. It concludes with a recommendation to approve or deny the change request.

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Jed de Leon
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82 views1 page

Change Impact Statement Template

This document communicates the impact of a requested project change. It includes the change request number, description of the change, and whether the change would impact the project's budget, schedule, scope, deliverables, resources, or quality. It concludes with a recommendation to approve or deny the change request.

Uploaded by

Jed de Leon
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOC, PDF, TXT or read online on Scribd
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<Insert Project Name>

Change Impact Statement


This form is used to communicate the impact of a requested change on the overall project.

Change Request Number:


<A unique identifier is assigned by the Project Manager as a “change request number”.>

Description of Change Requested

<This section provides a description of the requested change. This description can be taken from
the Change Request Form if one was completed.>

Impact of Change Request


Yes No Aspect of the Request Details

Budget <If yes, include actual estimated costs or savings.>

Schedule <If yes, give details of extensions needed or time that


can be saved.>

Scope <If yes, state how the request will affect the overall
scope of the project. State what elements are being
added or deleted.>

Deliverables <List all deliverables that will be affected, including


those that will need to change, those that will no
longer be required and new deliverables.>

Resources <If yes, state what new resources will be needed or


which resources will no longer be needed - - be sure to
include the cost or savings of the resource change in
your budget estimate.>

Quality <The degree to which a set of inherent characteristics


fulfils requirements.>

Other <If yes, list any other impacts of the change request.>

Recommended Action

<State clearly if you recommend that the change request should be approved or denied.>

Change Impact Statement

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